Patient-centered care is the delivery of care that is unique to each patient, individualized to their needs, and established through a shared patient–clinician decision-making process

Purpose: Although gender disparities and workplace vitality for women has been studied in athletic training, gender discrimination has not been widely studied. The purpose of this study was to describe gender-based aggressions experienced by women athletic trainers (ATs) within their educational and workplace environments. Methods: We used a cross-sectional design, and the web-based survey was comprised of demographic questions, the Schedule of Sexism Events (SSE), and questions on incident reporting. The SSE asks participant to rank items on a Likert Scale (1 = the event never happened to 6 = the event happens almost all the time). Items within the SSE are contextualized to either events in the past year or events in their entire life. The survey was distributed to 5,667 women ATs through the National Athletic Training Association (NATA). Five hundred thirty-nine (539) participants accessed the survey (9.5%). Four hundred seventy-eight (478) participants (age=34.2±8.6y [range=23–66y], experience=11.0±8.2y [range=0-40y]) completed the entire instrument (88.6%). We used descriptive statistics to analyze demographic variables, gender-based education- and work- related items of the SSE and incident reporting. Results: When asked about unfair treatment while interacting with teachers, professors, or engaging in academics in their lifetime, 89% (n=425) of participants indicated they had experienced unfair treatment. Comparatively, 53% (n=252) of participants experienced unfair treatment from teachers, or professors, or while engaging in academics in the last year. When asked about unfair treatment by an employer, boss, or supervisor, 88% (n=421) of participants experienced unfair treatment in their lifetime, where 55% (n=267) have experienced unfair treatment in the past year. Ninety percent (90%, n=430) indicated they experienced unfair treatment by co-workers, fellow students, or colleagues, in their lifetime compared to 61% (n=292) in the past year. When asked if they had experienced gender-based macroaggressions and microaggressions in the workplace, 41% (n=198) experienced both types of aggressions; 5% (n=22) experienced macroaggressions and 29% (n=137) experienced microaggressions. Only 25% (n=119) of participants have reported aggressions in the workplace. Conclusion: Women ATs experience gender-based aggressions in the workplace but they do not typically report these aggressions. All ATs have the responsibility to work towards an inclusive, equitable, and welcoming workplace that directly addresses aggressions.

Context: Psychological ownership (PO) is a state where an individual feels possession over an object (e.g. PO over the organization where one works, PO over the profession one serves). Understanding PO could provide insight to “vitality of the profession” as defined in the Prioritized Research Agenda for the Athletic Training Profession. Objective: The purpose of this study was to explore athletic trainers' (AT) PO over their employing organization and the athletic training profession. Design: Cross-Sectional Study Setting: Web-based survey Patients or Other Participants: Clinically practicing ATs that were active members of NATA. Main Outcome Measure(s): Demographic variables, Psychological Ownership Questionnaire (POQ), and Psychological Ownership of Athletic Training (POQ-AT) were the primary outcomes measured. Descriptive statistics were calculated for demographic variables, POQ and POQ-AT overall scores, form scores, and dimension scores. Non-parametric tests were used to investigate differences between the POQ and POQ-AT among demographic characteristics. Results: ATs indicated greater PO over the athletic training profession (Z=−3.45, p=0.001) than over their employing organization. They indicated greater belongingness (Z=−9.51, p<0.001) and self-identity (Z=−8.71, p<0.001) and less territoriality (Z=−5.52, p<0.001) and accountability (Z=−5.33, p<0.001) over their profession than within their organization. ATs that supervised others indicated greater overall POQ (U=34372, p<0.001) and overall POQ-AT score (U=36624, p=0.014) than ATs that did not supervise others. There was a difference in overall POQ (H(4)=20.47, p<0.001) and overall POQ-AT scores (H(4)=21.34, p<0.001) between groupings of years of experience. Conclusions: ATs indicate greater PO over their profession than their employing organizations. They indicate greater self-identity and belongingness and less territoriality and accountability over the athletic training profession than over their employing organization suggesting ATs are connecting aspirations and accomplishments with the profession but connecting duty and responsibility to their organizations. Years of experience and supervisor status may play a role in the level of organizational PO.

Purpose: Clinical leadership behaviors demonstrated by nurses delivering patient care are associated with improved patient outcomes and increased job satisfaction. Clinical leadership behaviors have not been studied in athletic training; therefore, the purpose of this study was to investigate athletic trainers’ frequency of demonstrating these behaviors. Method: Participates completed an electronically distributed survey consisting of demographic variables, the Clinical Leadership Survey (CLS), and the Global Rating of Clinical Leadership Scale (GRCLS). Results: We found statistically significant differences between the CLS score of those in a supervisory role (M = 65.3 ± 5.4) and those who are not (M = 63.5 ± 5.5, mean difference = 1.8 ± 0.8, t (212) = 2.27, p = 0.02). A moderate positive correlation (r = 0.51, p < 0.001) exists between an individual’s CLS score and perceiving themselves as a clinical leader. A moderate positive correlation (r = 0.59, p < 0.001) exists between an individual’s CLS score and believing they demonstrate leadership behaviors in clinical practice. Conclusion: Athletic trainers in supervisory roles report demonstrating clinical leadership behaviors more often than those who are not. A discrepancy exists between athletic trainers’ reported frequency of demonstrating individual clinical leadership behaviors, their belief they are leaders, and their demonstration of leadership behaviors. The data suggest athletic trainers who are not in supervisory roles may believe, because they hold no positional authority, they are not clinical leaders. Organizations can implement strategies to promote clinical leadership in staff and improve patient outcomes.

Purpose: Typically, athletic trainers (ATs) have relied on external support networks to debrief after a critical incident (CI). ATs report focusing on improving work-related processes after a CI rather than their emotional response to the CI. The purpose of this study was to identify both the short-term emotional impacts of CIs and what coping strategies ATs use to address their emotional response to CIs. Methods: We used a cross-sectional, web-based survey, distributed to a random sample of NATA members to explore the perceived effects of CIs on ATs. Participants (n=73, 36±11y) were primarily women (n=53, 72.6%), working in the college/university practice setting (n = 40, 54.8%), with 7±3y of experience. All participants experienced a CI within the previous 12 months. The data were analyzed using descriptive statistics for demographic variables and multi-analyst inductive coding for the open-ended items amongst a 4-person team. We used a modified consensual qualitative research (CQR) process to review and analyze the open-ended questions and identify domains and core ideas. Trustworthiness was established with multi-analyst triangulation and auditing. Results: Participants most commonly reported feelings of thinking too much (71%, n=52), anxiety (63%, n=46), sadness (60%, n=44), fatigue (53%, n=39), and sleep disturbance (49%, n=36) resulting from CIs. Common coping strategies used were exercise (63%, n=46), humor (44%, n=32), interacting with pets (41%, n=30), expressing oneself through crying (40%, n=29), and peer support (34%, n=25). Sixty-two participants (86%) responded to open-ended questions related to the outcomes of CIs. Four domains were identified from the open-ended responses. Those domains included 1) dissociation, 2) deteriorated emotional state, 3) disruption of daily activities, and 4) improved event or post-event processes. Conclusion: Various strategies are used by ATs to cope with CIs; however, the only ways in which ATs expressed that coping helped was with care delivery, not the emotional impact of the CI. The lack of responses relative to coping strategies that improve quality of life is potentially alarming. To build resilience and persistence, organizations should consider requiring support beyond process improvement that addresses the emotional impact of CIs.

Context: Disparities in the healthcare system persist in society today, affecting both minoritized patients and providers. A diverse healthcare workforce is ideal to treat a patient population that is also becoming increasingly diverse. We examined the experiences of minoritized students pursuing healthcare-related degrees, including athletic training, in pre-medicine and healthcare professions. Methods: We used a phenomenological approach to explore the lived experiences of 10 minoritized pre-medicine and healthcare profession students (age=20±2 years). Participants engaged in an online semi-structured interview (Zoom, San Jose, CA). All interviews were audio-recorded and transcribed. We used a consensual qualitative research (CQR) approach with a 3-person data analysis team and multi-phase coding approach to identify core ideas. The data analysis team established a consensual codebook that was applied to all the transcripts. The consensus codebook’s trustworthiness and credibility were established through member checking, multi-analyst triangulation, and auditing. Results: Three domains were identified regarding minoritized pre-medicine and healthcare profession students relating to their experiences while pursuing their respective graduate degrees, including athletic training (Figure 1): 1) Belonging 2) Relationships 3) Preparation. Minoritized pre-health profession students want to experience more diversity and inclusion in the healthcare system. Feelings of belonging, relationships with others, and prior experiences of preparation help to encourage these students to pursue careers in healthcare, although barriers still exist. Focused professional resources are needed to continue supporting minoritized students in their pre-healthcare programs. Conclusions: Minoritized learners want to see and be represented in healthcare. Colleges and universities must tailor individualized resources to minoritized learners to help increase diversity in the healthcare system.